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No 3 (2017)


Early diagnosis of risk for developing calcium oxalate urolithiasis

Apolikhin O.I., Sivkov A.V., Konstantinova O.V., Slominskii P.A., Tupitsyna T.V., Kalinichenko D.N.


Aim To identify risk groups for calcium oxalate urolithiasis among healthy individuals and patients with urolithiasis in the Russian population using molecular genetics. Materials and methods The study comprised 72 patients with calcium oxalate urolithiasis (study group) and 189 healthy adults from the general Russian population (control group). The study group consisted of 39 (54.2%) men and 33 (45.8%) women. The mean age of urolithiasis patients was 41.5+12.4 years. Analysis of polymorphic variants of 8 candidate urolithiasis genes: tumor necrosis factor 11B (TNFRSF11B, rs3134057), а-subunit of the nuclear estrogen receptor (ESR1, rs851982), Cloto gene (KL, rs526906), vitamin D receptor (VDR, rs1540339 ), an extracellular calcium-sensing receptor (CASR, rs2202127), membrane anion transporter family 26 (SLC26A6, rs2310996), tumor necrosis factor 11 (TNFSF11, rs9525641), the calcium release-activated calcium modulator 1 (ORAI1, rs7135617) in two groups was performed by real-time PCR using Applied Biosystems test. Statistical analysis was performed using Fisher’s angular transformation and χ2. Results In the polymorphism of the ORAI1 gene (rs7135617), the differences in the frequencies of the GG genotype and the G allele in the control sample and in the sample of patients with calcium oxalate urolithiasis were significant: p=0.0004 and p=0.001, respectively. No statistically significant differences in the genotype and allele frequencies were found in the remaining seven gene polymorphisms. Conclusions Healthy individuals and patients with urolithiasis in the Russian population who have the GG genotype and/or the G allele of the polymorphism of the ORAI1 gene (rs7135617) represent risk groups for the formation of calcium oxalate stones.
Urologiia. 2017;(3):5-9
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Is bacteriological testing of bladder urine informative in acute obstructive pyelonephritis?

Kogan M.I., Naboka Y.L., Bedzhanyan S.K., Mitusova E.V., Gudima I.A., Morgun P.P., Vasil’eva L.I.


The problem of the etiology and pathogenesis of acute obstructive pyelonephritis (OOP) remains one of the challenging issues of modern urology. Etiological agents of pyelonephritis can be both gram-negative and gram-positive opportunistic bacteria mostly belonging to the normal flora in humans. The generally accepted diagnostic work-up involves a bacteriological testing of not pelvic urine, but of bladder urine collected by a transurethral catheter or midstream specimens of urine collected from the patients. The aim of our study was to compare the microbiota of bladder and pelvic urine in patients with OOP. Materials and methods. The study comprised 72 sequentially selected patients (12 men and 60 women) with OOP associated with ureteral stones. Mean age of patients was 53.7±0.5 years. All patients underwent bacteriological examination of the bladder urine collected by a transurethral catheter and pelvic urine obtained after relieving stone-related ureteral obstruction. Urinary diversion was performed using j-j stent and PCN in 64 and 8 patients, respectively. Preoperative prophylactic antibiotics were administered routinely. Bacteriological testing of urine was carried out using an extended set (9-10) of culture media. Empirical antibiotic therapy was initiated only after the restoration of urine outflow from the kidney and continued for 5-6 days until the availability of bacteriological testing results. Results. Levels of bacteriuria with Enterobacteria, gram-positive pathogens and NAB in two urine samples did not differ significantly (p>0.05). There was a wide range of bacteriuria from 101 to 106 CFU/ ml of most microorganisms except @Proteus spp., S. aureus. In bladder urine, the rates of bacteriuria of ≥104 CFU/ml for E. coli, Klebsiella spp. and Proteus spp. were 90.9%, 72.7% and 100.0%, respectively. For the remaining microorganisms, predominant bacteriuria was ≤103 CFU/ ml. In pelvic urine, the rates of bacteriuria of ≥104 CFU/ml for E. coli, Klebsiella spp. and Proteus spp. was 71.8%, 40.0% and 66.7%, respectively. Other uropathogens in the pelvic urine mainly had a bacterial count of ≤103 CFU/ml. Only the concentration of Corynebacterium spp. in the pelvic urine significantly (p=0.023) differed from that of the bladder urine. There were no significant differences between microbiota of bladder and pelvic urine depending on duration of OOP except higher rates of Corynebacterium spp. in the bladder urine.
Urologiia. 2017;(3):10-15
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Experience in using Phytolysin in the integrated management of urinary tract infections and methapylactics of nephrolithiasis

Saenko V.S., Kapsargin F.P., Pesegov S.V., Troyakov V.M.


Relevance. Urinary tract infection (UTI) are a risk factor for diseases leading to impairment of renal function and kidney stone disease (KSD). Growing resistance of uropathogens to antibacterial agents is a challenging issue in most countries of the world. Urolithiasis is the second most prevalent urologic condition following urinary tract infections and has a pronounced tendency to recur. Rational stone metaphylaxis leads to a significant reduction in the incidence of recurrent stones. In recent decades, there has been a markedly increasing interest in plant-based therapies in managing urologic diseases. Aim. To evaluate the effectiveness of phytotherapeutic medication Phytolysin in the integrated management of UTI and metaphylaxis of urolithiasis. Materials and methods. Comprehensive evaluation of the effectiveness of Phytolysin was conducted at the Department of Urology, I.M. Sechenov First MSMU and Department of Urology, Andrology and Sexology, Voino-Yasenetsky Krasnoyarsk SMU in 40 women with episodes of exacerbation of chronic cystitis and 30 patients of both sexes during the postoperative metaphylaxis of the KSD. The age of the patients ranged from 20 to 68 years (mean age 40±2,8 years). Results. Adding Phytolysin to the integrated management results in the improvement in general clinical signs and laboratory parameters of blood and urine, leads to a decrease in the level of leukocyturia, bacteriuria and an increase in diuresis and urinary alkalinization, reduces the number relapses of UTI and stone formation. Conclusion. Phytolysin is an effective and safe medication.
Urologiia. 2017;(3):16-21
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Using L-and acetyl-L-carnintines in combination with clomiphene citrate and antioxidant complex for treating idiopathic male infertility: a prospective randomized trial

Bozhedomov V.A., Lipatova N.A., Bozhedomova G.E., Rokhlikov I.M., Shcherbakova E.V., Komarina R.A.


The most common cause of male infertility is idiopathic oligo-, and or astheno-, and /or teratozoospermia. In such cases, anti-estrogens, antioxidants (vitamins and trace elements) or carnitines are used, but the evidence on their effectiveness is inconsistent; there are currently no published studies exploring their concurrent use. Aim. To investigate the efficacy and safety of the L- and acetyl-L-carnitine complex, vitamins A, E, C, selenium, zinc and other antioxidants («SpermActin®» + «More than vitamins»®) in combination with clomiphene citrate (CC) in managing male idiopathic infertility in the form of oligo, and/or astheno-, and/or teratozoospermia. Materials and methods. The study comprised 173 men from infertile couples aged 25-45 years who were divided into two groups - the study group (n=88) and control group (n=85). All the patients were examined according to the WHO recommendations. Patients of the study group received L-carnitine fumarate (1 g), acetyl-L-carnitine (0.5 g) twice daily, a complex of vitamins and microelements and CC 25 mg twice daily orally. Patients of the control group were administered the same dosages of CC and a complex of vitamins. Ejaculate was evaluated before and after 3-4 months of treatment. Six months after the start of treatment, information about the onset or absence of pregnancy over the last six months was collected via telephone or online survey. Results. Co-administration of L- and acetyl-L-carnitines concurrently with CC and antioxidant complex (vitamins and minerals) in patients with idiopathic oligo- and/or asteno- and/or teratozoospermia provides some additional positive effect on the concentration of spermatozoa, more pronounced in patients with multiple impaired semen parameters - oligoasthenoteratozoospermia, but does not improve the morphology, progressive sperm motility and pregnancy rates compared to patients receiving basic treatment.
Urologiia. 2017;(3):22-32
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Systematic approach in performing isolated and simultaneous operations in elderly patients with prostate adenoma

Leshchenko I.G., Bratchikov O.I., Yakovlev O.G., Shatokhina I.V., Shumakova E.A., Artishchev S.O.


Aim. To develop a scientifically based system for treating elderly patient with prostate adenoma (AP), aimed at reducing the incidence and severity of complications and mortality after isolated and simultaneous operations. Materials and methods. Between 1995 and 2015, 1170 elderly and older patients with prostate adenoma (PA) underwent isolated adenomectomy (AE) or transurethral resection of the prostate (TURP) or simultaneous operations (SO). Simultaneous interventions were performed in 335 (28.6%) patients. Results. Immediate treatment results were significantly better in patients who underwent isolated TURP or TURP as a part of SO than that of those who had isolated AE or AE as a part of SO. SO was not associated with greater incidence of local or general postoperative complications and mortality compared with isolated AE or TURP. Conclusion. Continuous advancements in diagnostic and treatment methods contributed to a significant reduction in the incidence of postoperative complications and deaths in geriatric patients with PA. The study findings confirm the superiority of TURP over AE, as previously reported by other authors.
Urologiia. 2017;(3):33-39
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Laparoscopic pyelolithotomy for staghorn kidney stones. A multi-center study

Kochkin A.D., Gallyamov E.A., Medvedev V.L., Biktimirov R.G., Martov A.G., Sevryukov F.A., Novikov A.B., Sanzharov A.E., Sergeev V.P.


Aim. To analyze the effectiveness and safety of laparoscopic pyelolithotomy (LP) in treating staghorn stones. Materials and methods. A multicentre retrospective analysis of the results of LP performed from January 2004 to December 2016 was conducted. Inclusion criteria: patients with staghorn calculi K3-K4, who underwent LP as an alternative to percutaneous nephrolithotripsy. The analysis included the incidence and structure of intra- and postoperative complications, the causes of access conversion, operating time, duration of postoperative hospital stay and stone clearance. Results. A total of 137 patients met the inclusion criteria, including 78 (56.93%) men. There was no mortality and access conversion. Intraoperative complications occurred in 2 (1.46%) patients. Operating time was 130 [100; 150] min, blood loss was 150 [100; 200] ml. No need for blood transfusion was observed. The cumulative rate of postoperative complications was 5.11%, stone clearance was achieved in 86.13% of observations, the duration of postoperative hospital stay was 7 [7; 11] days. Conclusion. In cases of dense staghorn calculi located in a large «extrarenal» pelvis and have calyceal branches equal to the diameter of their necks, laparoscopic pyelolithotomy is an alternative not only to open, but also to percutaneous surgery.
Urologiia. 2017;(3):40-45
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Questions of terminology, systematization and grading of complications of contact ureteral lithotripsy

Dutov V.V., Bazaev V.V., Mamedov E.A., Urenkov S.B., Podoinitsyn A.A.


Aim. To investigate the advantages and disadvantages of the current variants of systematization and grading of complications of contact ureteral lithotripsy (CULT) and develop a working classification of CULT complications. Materials and methods. The study analyzed results of 545 fluoroscopy-guided endoscopic procedures performed at the MRRCI Clinic of Urology from 2008 to 2015 in 506 patients with ureterolithiasis. Results. The proposed and implemented classification and terminology of CULT complications unifies the diagnostic and management algorithm. This tool is more systematic and structured than the classical classification and universal methods of systematization and grading of CULT complications (classifying CULT complications in «major» and «minor», PULS scale, Satava and Clavien-Dindo grading systems). Given the lack of clear grading of ureteral rupture, it was divided into amputation (two-level rupture) and avulsion (one-level rupture). Using such term as extravasation of the contrast media and/or migration of the stone outside of the ureter is groundless because these complications occur only after the perforation of the ureteral wall. Therefore, these conditions are complications not of CULT, but of the ureteral wall perforation. The ureteral perforation was classified into macro- and micro-perforation. Conclusion. The existing terminology, classification and grading of the CULT complications should undergo a more detailed analysis. None of the existing classifications of CULT complications afford them to be fully staged and systematized. The working classification of complications of CULT developed at the M.F. Vladimirsky MRRCI Clinic of Urology warrants a multi-center prospective study to validate it and investigate its effectiveness.
Urologiia. 2017;(3):46-53
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Experience in ureteroscopy for managing urolithiasis in one clinic. when does quantity transform into quality?

Ivanov V.Y., Malkhasyan V.A., Semenyakin I.V., Pushkar D.Y.


Introduction. In recent years, there has been an increasing role of ureteroscopy in managing urinary tract calculi of various locations. Several studies have reported the relationship between the efficacy and safety of ureteroscopic interventions and surgeon’s skills and hospital caseload volume. The aim of our study was to assess the effectiveness of urethroscopic stone removal, the changes in treatment effectiveness, frequency and types of complications along with gaining experience in these interventions. Materials and methods. We analyzed 4031 urolithiasis patients who were admitted to our urological department and underwent ureteroscopy from 2001 to 2013. To determine the effectiveness and safety of the method, as the experience gained, the time of observation was divided into three periods: from 2000 to 2004, from 2004 to 2009, from 2009 to 2013. The parameters were evaluated for the entire observation time and for each period. Results. Complete fragmentation of the stones was observed in 3628 (90%) patients, partial - in 219 (5.4%). No treatment effect was observed in 138 (3.4%) patients. The greatest effectiveness (96.94%) was seen in stones in the lower third of the ureter. The proportion of unsuccessful ureteroscopies was 5.7%, 4.5% and 3.5% for the periods 2000 -2004, 2005-2009 and 2009-2013, respectively (p=0.027). The incidence of acute postoperative pyelonephritis in the corresponding periods was 15.4%, 3.3% and 2.9% (p<0.001). Conclusion. Ureteroscopy is an effective and safe treatment modality for managing upper urinary tract calculi. It is most effective in treating distal ureteral stones. The increase in the treatment effectiveness and the reduction in the incidence of complications along with gaining experience, suggests that these interventions should be practiced mainly in urology centers specializing in the care of patients with urolithiasis.
Urologiia. 2017;(3):54-59
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High oncogenic risk human papillomavirus and urinary bladder cancer

Loran O.B., Sinyakova L.A., Gundorova L.V., Kosov V.A., Kosova I.V., Pogodina I.E., Kolbasov D.N.


Aim. To determine the role of human papillomavirus (HPV) of high oncogenic risk in the development of urinary bladder cancer. Materials and methods. 100 patients (72 men and 28 women) aged 38 to 90 years (mean age 65±10 years) diagnosed with bladder cancer were examined and underwent treatment. Clinical assessment was complemented by enzyme-linked immunosorbent assays for the presence of antiviral antibodies to herpes simplex virus (HSV) type 1 and type 2, cytomegalovirus (CMV), Epstein-Barr virus (EBV), urethra scraping for detecting high oncogenic risk HPV. Tumor tissue was sampled for PCR virus detection. Semi-quantitative analysis was used to evaluate the components of lymphocyte-plasmocyte and leukocyte infiltrates and cytopathic changes in tumor tissue. Results. There were positive correlations between cytopathic cell changes (koylocytosis and intranuclear inclusions, as manifestations of HPV) and the level of antiviral antibodies, the presence of viruses in the tumor, as well as with the components of the lymphoid-plasmocyte infiltrate. Negative correlations were found between the presence of papillomatosis and the above changes. Conclusion. Human papillomavirus is believed to be a trigger for the initiation of a tumor in young patients with a latent infection (CMV and EBV, HSV, HPV). Cytopathic changes (kylocytosis and intranuclear inclusions) were associated with the activity and morphological features of herpes-viral infections. Their degree varied depending on the stage of the process, but not on the anaplasia degree. Papillomatosis is associated with a more favorable course of the tumor process.
Urologiia. 2017;(3):60-67
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Ultrasound-guided percutaneous cryoablation of renal tumors

Enikeev D.V., Glybochko P.V., Alyaev Y.G., Rapoport L.M., Amosov A.V., Alekseeva T.M., Enikeev M.E., Tsarichenko D.G., Chinenov D.V., Kozmin L.D., Dzhalaev Z.K., Taratkin M.S.


Introduction. Surgery remains the gold-standard curative treatment for localized (T1) renal carcinoma. However, recent medical-technological advances have led to the development of new minimally invasive treatment options, one of which is percutaneous cryoablation. Aim. To assess the effectiveness and safety of ultrasound-guided percutaneous cryoablation of renal tumors. Materials and methods. The study comprised 12 patients aged 52 to 76 years who underwent ultrasound-guided percutaneous cryoablation of renal tumors from 2015 to 2017. In 11 patients, the size of the renal mass was 3.0 cm (T1a), in 1 patient 4.5 cm (T1b). A Doppler ultrasound, contrast-enhanced MSCT and computer 3D modeling were performed in all patients pre-operatively and 6 months after surgery to assess the tumor’s size and extent and the spatial location of the tumor internal surface to the pelvicalyceal system. In all patients, the tumors were located along the posterior or lateral surface of the kidney, in the lower or middle segment and without sinus invasion. We used a 3rd generation Galil Medical’s SeedNet Gold Cryotherapy System and IceSeed and IceRod cryoprobes. Intraoperatively, immediately before cryoablation, the tumor was biopsied. In all patients the diagnosis of renal cell carcinoma was confirmed morphologically. Results. Mean duration of cryoablation was 60 minutes. Endotracheal, spinal, local and intravenous anesthesia was used in 1, 6, 5 and 1 patients, respectively. Doppler ultrasound at 6 months after surgery showed that in 11 patients (T1a) the tumor size decreased on average by 8 mm, with no blood flow in the tumors. MSCT with 3D modeling also revealed a decrease in tumor size and total absence of contrast agent accumulation, or accumulation gradient not exceeding 10 HU (initially it was about 200 HU). In the patient with T1b stage renal carcinoma, MSCT showed a decrease in tumor size from 4.5 to 3.7 cm, however, there was a mass up to 1.5 cm with a high gradient of contrast agent accumulation. The patient underwent kidney resection. No intra- and postoperative complications were observed. Conclusion. The accumulated experience allows to confirm the effectiveness and safety of ultrasound-guided percutaneous cryoablation and to consider it a method of choice for patients with stage T1a renal carcinoma located along the posterior or lateral surface of the kidney in the lower or middle segment, without sinus invasion.
Urologiia. 2017;(3):68-73
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An injury of major vessels during laparoscopic procedure in urology. Surgical management by analyzing of clinical cases

Biktimirov R.G., Martov A.G., Biktimirov T.R., Kaputovskij A.A.


An injury of major vessels is a life - threating complication in laparoscopic urology. Review of the literature and analysis of own cases have been performed. The authors offer original surgical management with using hand-assistant technic. It has advantages of open and laparoscopic approach.
Urologiia. 2017;(3):74-77
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Laparoscopic cystoprostatvesiculeectomy with orthotopic excentric ileal bladder substitution

Glybochko P.V., Alyaev Y.G., Shpot' E.V., Pshikhachev A.M., Mosyakova K.M., Nikolaeva A.S.


There are numerous options for forming an orthotopic bladder by the source tissue and the shape of the urinary reservoir. In our practice, we use the technique reported by Karolinska Institute (Sweden). This technique allows us to form a neobladder most resembling the natural urinary bladder in the shape and volume. The article presents a clinical observation describing this technique in a 63 year old patient who was initially diagnosed with bladder cancer pT2N0M0G3 and underwent transurethral resection of the bladder wall with the tumor. Thereafter, the patient underwent laparoscopic cystoprostatvesicleectomy with extended pelvic lymph node dissection and orthotopic ileal bladder substitution. His upper urinary tract on both sides was drained by ureteral stents with external diversion. The eccentric suturing technique makes it possible to form an oval-shaped urinary reservoir that is anatomically and functionally most comparable to a healthy man's bladder.
Urologiia. 2017;(3):78-83
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Penile revascularization using laparoscopic mobilization of the inferior epigastric artery

Kyzlasov P.S., Abdulkhamidov A.N., Sergeev V.P., Bokov A.I., Volodin D.I., Zabelin M.V.


The article presents a case of successful penile revascularization using laparoscopic mobilization of the inferior epigastric artery in a 35 y. o. patient with penile arteriovenous insufficiency.
Urologiia. 2017;(3):84-85
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Laparoscopic antevasal uretero-ureteral anastomosis for treating retrocaval ureter

Komyakov B.K., Guliev B.G., Idrisov S.N., Shibliev R.G.


The article presents a case of laparoscopic antevasal correction of the retrocaval ureter in a 16 year old patient, who was admitted to the hospital with complaints of aching pain in the right lower back. His history was noteworthy of early age onset of intermittent fever accompanied by abdominal and lumbar pain. Blood count and urinalysis were within normal limits, and he was treated symptomatically. However, no renal ultrasound scan was done. Intravenous urography and MSCT showed a retrocaval ureter. The diagnosis was confirmed by retrograde ureteropyelography. With the patient placed in the lateral position, the right ureter was mobilized by transperitoneal access, transected and mobilized from under the inferior vena cava. Anterior uretero-ureteral anastomosis on the stent was performed, drainage was established. The operating time was 90 minutes, blood loss was 60 ml. There were no postoperative complications. Drainage was removed 2 days after surgery and the patient was discharged for outpatient treatment. The stent was removed 6 weeks postoperatively. Control urography showed normal function of both kidneys, no urodynamic abnormality of the upper urinary tract was identified
Urologiia. 2017;(3):86-91
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Nephrolithiasis coexisting with type 2 diabetes: current concept of the features of stone formation and the effects of hypoglycemic therapy on lithogenesis

Yarovoi S.K., Golovanov S.A., Khaziakhmetova M.R., Dzhalilov O.V.


The article analyzes Russian and international literature examining specific features of the pathogenesis of renal stones in the setting of carbohydrate metabolism disorders. The authors outline the renal effects of the main pharmacological groups of oral hypoglycemic drugs regarding metaphylaxis of nephrolithiasis. An increased risk of nephrolithiasis in type 2 diabetes mellitus is realized through hyperuricemia with concurrent urine acidification. Current literature is lacking studies on the effects of oral hypoglycemic drugs on urine properties. There are reports about the tendency of biguanides (metformin) to shift the urine reaction to the acid side. Derivatives of sulfonylureas, incretins and inhibitors of dipeptidyl peptidase-4, do not significantly affect the urinary acidity and urinary salt excretion. Inhibitors of sodium-glucose cotransporter type 2 (gliflozins) tend to reduce the blood level of urate, but the mechanism of this effect and the safety of these drugs in the setting of urolithiasis have not yet been investigated.
Urologiia. 2017;(3):92-97
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Dual energy computed tomography in diagnosis of urolithiasis: a new method for determining the chemical composition of urinary stones

Martov A.G., Mazurenko D.A., Klimkova M.M., Sinitsyn V.E., Nersisyan L.A., Gadzhiev N.K.


The «gold standard» for the diagnosis and evaluation of urinary stones is native computed tomography, which allows determining stone localization and size of with high accuracy. However, this imaging technique has limited diagnostic usefulness in determining the stone chemical composition. The newly introduced method of dual-energy computed tomography, based on obtaining images at two different energy levels is highly effective in determining the composition of urinary stones. The review outlines the principles and methods of performing dual-energy computed tomography using various scanners. The authors analyze the results of using this method for diagnosing urolithiasis, determining the stone chemical composition and point out the limitations and difficulties encountered in its application.
Urologiia. 2017;(3):98-103
pages 98-103 views

Resistance of urinary tract pathogens and the choice of antimicrobial therapy: deceptive simplicity

Rafalskiy V.V., Dovgan’ E.V.


Urinary tract infection (UTI) is one of the most common reasons for prescribing antibiotics in outpatient and inpatient settings. One of the main criteria for selecting antimicrobial drugs for treating UTI is data on the antibiotic resistance of uropathogens. The article discusses the difficulties in interpreting the results of antimicrobial sensitivity testing of uropathogens and the impact of antibiotic resistance of uropathogens on the clinical effectiveness of managing UTI.
Urologiia. 2017;(3):104-111
pages 104-111 views

The role of mycoplasma infection (M. hominis and U. urealyticum) in inflammatory diseases of the genitourinary system - the debate continues

Khryanin A.A., Reshetnikov O.V.


The article presents current views on urogenital diseases caused by M. hominis and U. urealyticum. Particular attention is paid to concurrent (co-occurring) urogenital infections. The review reports the data from epidemiological studies and outlines recent Russian and international guidelines and consensuses on managing patients with urogenital inflammatory diseases. The importance of adequate diagnosis and rational therapy of urogenital infections is discussed.
Urologiia. 2017;(3):112-119
pages 112-119 views

PDE-5 inhibitors: patients’ preferences

Efremov E.A., Kasatonova E.V., Mel’nik Y.I., Nikushina A.A.


To date, multidisciplinary approach is commonly used to treat erectile dysfunction (ED), and the first line of ED pharmacotherapy, despite its multiple causes, is phosphodiesterase inhibitors of type 5 (PDE-5). They are considered an effective and well tolerated treatment option [1-4]. Concurrently, sildenafil has the largest evidence base for efficacy and safety [5]. The satisfaction of patients with ED therapy is a complex and personal matter, and there are no clearly established and reliable criteria for showing preferences when choosing a PDE-5. Adherence of patients to the PDE-5 therapy is determined not only by the erectile response and side effects, but also by how well the treatment meets the needs and expectations of patients and how it affects the relationship between the partners. This review examines the tolerability and efficacy of the various types of PDE-5 available for treating ED, with a special emphasis on the patient's preferences, and in particular on the new sildenafil orodispersible films. As an alternative route of drug administration, films quickly dissolve in the mouth [6] and have several advantages, improve sexual health and the sense of psychological well-being of patients and their partners.
Urologiia. 2017;(3):120-126
pages 120-126 views

American urological association guideline for diagnosis and management of male urethral stricture 2016

Zhivov A.V., Reva I.A., Tedeev R.L., Pushkar D.Y.


The article provides coverage of the main features of the American Urological Association (AUA) Guideline for the diagnosis and management of male urethral stricture published in 2016. Clinical guideline on this medical condition is published for the first time and is unique in the world of urology. The authors present their comments based on the accumulated experience of diagnosis and treatment of this urological condition.
Urologiia. 2017;(3):127-137
pages 127-137 views

Russian experience with Vitaprost Forte suppositories in patients with lower urinary tract symptoms and benign prostatic hyperplasia: comparative analysis of studies

Korneev I.A.


The article reviews the domestic studies showing the efficacy and safety of suppositories containing prostate extract (Samprost substance) Vitaprost Forte in treating men with lower urinary tract symptoms secondary to benign prostatic hyperplasia. The data obtained by Russian specialists confirm the effectiveness of Vitaprost Forte suppositories in managing patients with moderate LUTS and infravesical obstruction caused by BPH to reduce dysuria, improve the quality of life and normalize urodynamic parameters.
Urologiia. 2017;(3):138-144
pages 138-144 views

Boris Kirillovish Komyakov (on the 65th anniversary)

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Urologiia. 2017;(3):145-146
pages 145-146 views

Sergei Petrovich Darenkov (on the 60th anniversary)

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Urologiia. 2017;(3):146-146
pages 146-146 views

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